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KMID : 0378019780210070098
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New Medical Journal
1978 Volume.21 No. 7 p.98 ~ p.102
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A Study on the Psychiatric Discharges Against Medical Advice
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Abstract
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As a preliminary study on the psychiatric discharges against the medical advice, the writer is intended to specify the causative factors in four psychiatric patients prematurely discharged against. the medical advice from the private psychiatric hospital during three months since January, 1978 from. the view point of the various influential aspects.
The influential causative factors which are considered in the case of `obsessive-compulsive neurosis´ (case 1) are the parent´s neurotic conflicts and ambivalent attitude toward the psychiatric.. hospitalization for one of their family members, the patien´s psychopathology, and repulsive therapeutic attitude of the therapist, and in the case of personality disorder (Case 2),"the factor is the rejection of the treatment by the therapist against the patient´s hostility and insult toward him and in the case of masked depression (case 3), the factor is the resistance of the patient caused by somatization as a mean of the defensive mechanism, and in the case of schizophrenia (case 4) the factor is the traditional concepts for the mental disease.
Considering from the above research, each case respectively has individualistic and idio syncratic features, and moreover in the case 1, 2,3 the discharge against the medical advice by the.patient is mainly connected with the inadequate therapeutic attitude and ability.
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